South Middlesex Times

Autism rates in the United States have reached a peak, with approximately one in 31 children now identified with autism spectrum disorder (ASD), as reported by the Centers for Disease Control and Prevention (CDC) on April 15. This marks a 22% increase since 2020 and a 375% rise since monitoring began in 2000. The data was collected by the CDC's Autism and Developmental Disabilities Monitoring Network from 16 communities across the nation.

New Jersey reported a slightly higher rate of 3.4%, or one in 29 children, representing a 18% increase in two years. A notable demographic change shows that for the first time, autism is more common among minority children. Rates per 1,000 children were highest among Asian and Pacific Islander (38.2), American Indian and Alaska Native (37.5), Black (36.6), and Hispanic (33) groups compared to 27.7 for white children.

Walter Zahorodny, an associate professor of pediatrics at Rutgers New Jersey Medical School, commented on this shift: "There's been a very interesting, barely acknowledged and not understood shifting in the demographic profile of autism." He noted the reversal from the previous trend where autism was mostly found in affluent and white communities.

The report also noted geographical variations, with the prevalence ranging from 9.7 per 1,000 children in Texas (Laredo) to 53.1 in California (covering part of metropolitan San Diego). Zahorodny highlighted the reliability of the data: "These are data based on population-based, highly rigorous epidemiologic methods, procedures and quality assurance practices." He added that the methodology avoids inaccurate ascertainment of cases.

A shift in economic patterns was also observed, with lower neighborhood median household incomes correlating with higher prevalence rates. Zahorodny stated, "I would expect Black, Hispanic, Asian rates slowly to approach and to be the same as white rates if there was a case-finding issue or a lack of access-to-services issue."

Disparities in co-occurring intellectual disability were also reported. Among children with autism who underwent cognitive testing, 39.6% also had intellectual disability, with much higher rates among Black (52.8%), American Indian and Alaska Native (50%), and Asian and Pacific Islander (43.9%) children compared to white children (32.7%).

Efforts to diagnose cases early are showing results. Children born in 2018 were 1.7 times more likely to be diagnosed with autism by age four than those born in 2014. The COVID-19 pandemic briefly hindered evaluations and diagnoses, but the trend in rising identification continued afterward. The CDC report highlighted the benefits of early identification, stating, "Early identification of ASD can help children receive services and supports they might need for their development and to improve long-term outcomes."

Zahorodny disputed the common explanations for the significant rise in autism cases. He rejected the notion that better awareness or an evolving definition of autism were responsible for the increase, saying, "The conventional answer, which has been given ad nauseam for the past 15 years, is that this gigantic increase is due to either better awareness of autism or a shifting definition of autism. Neither one of these is correct."

Autism's causes remain elusive, with little success in finding genetic causes and limited study on environmental triggers. Studies have identified some risk factors such as parental age, multiple births, cesarean section delivery, prematurity, and certain maternal medications, but these do not account for the full extent of the increase in autism prevalence. Zahorodny commented, "No real effort is made to try to identify the environmental triggers or risk factors that are involved in the true escalation of autism prevalence."

The researchers concluded that the increasing prevalence of autism necessitates greater demand for diagnostic, treatment, and support services, and highlights the opportunity to learn from communities with successful strategies. The CDC report stated, "Increased identification of autism, particularly among very young children and previously under-identified groups, underscores the increased demand and ongoing need for enhanced planning to provide equitable diagnostic, treatment and support services for all children with ASD."